Oncology: Improved diagnosis and treatment of malignant oncological disorders

One goal of the Clinical PET Group is to improve the diagnosis and treatment of malignant tumours with the specific aim of optimizing modern therapeutic procedures in Oncology and investigating tumour physiology through clinical studies.  Our main focus here is on the development of techniques for monitoring the efficacy of new molecular approaches to treatment. 

General Oncology: Earliest possible recognition of failed responses to treatment

In close cooperation with the Department of Nuclear Medicine, the Department of Clinical Medicine 1 and the Centre for Integrated Oncology, FDG-PET and FLT-PET are performed in patients with advanced, non-small cell bronchial carcinoma (NSCLC).  The patients undergo modern forms of therapy, including treatment with tyrosine kinase inhibitors.  However, since not all patients respond to such treatment, the investigations also serve to identify failed responses to therapy at the earliest possible stage.

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Neurooncology: Monitoring of the effects of therapy by PET

Fig. 1 Imaging of gliomas by means of MRI and PET to demarcate biologically active tumour tissue, low- and high-grade gliomas, recurrence and radiation necrosis, and to distinguish functionally important brain areas

Studies on patients with brain tumours

Studies on patients with brain tumours are carried out in close cooperation with the Department of Neurology at Cologne University.  The Max Planck Institute for neurological Research has long-standing expertise in the imaging of biological activity in brain tumours via PET.  Specific molecular processes, such as the expression of cellular enzymes and receptors, and the activity of membrane transporters can thus be localized and quantified.

Techniques used in these studies include enzyme-mediated enrichment, transporter-mediated accumulation and receptor-mediated binding of specific radioactively-labelled substrates.

PET provides a basis for quantitative analysis of various metabolic processes in primary brain tumors.  Active tumor tissue shows

  • A relatively increased glucose metabolism
  • Raised uptake of amino acids
  • Increased DNA synthesis (see Figs 1 and 2)

A key aspect of Neurooncology is monitoring of the effects of treatment by PET.  The aim here is to identify failed responses to modern forms of treatment at an early stage (Dr Schroeter, Dr Galldiks).

 

Fig. 2 Monitoring of response in a brain tumor patient under chemotherapy with a good response to treatment